AB0603 Increased Incidence of Raynaud’s phenomenon in Giant Cell Arteritis, possibly associated with Large Vessel Giant Cell Arteritis.
Authors: B. Slijkhuis, M. Sandovici, A. Eman Abdulle, K. van der Geest, E. Brouwer, D. J. Mulder
Journal: Annals of the Rheumatic Diseases (2022)

Background Large Vessel Giant Cell Arteritis (LV GCA) can cause significant narrowing of the subclavian and axillary arteries, either by inflammation or remodelling, which reduces blood pressure in the arms. Also, Raynaud’s phenomenon (RP) has been observed in GCA patients. Objectives This study aims to investigate the presence of Raynaud’s phenomenon in patients with GCA. Methods Patients diagnosed with GCA were given a validated questionnaire (CSQ) 1 on symptoms fitting RP, divided into the different phases of RP (white, blue/purple, and red discoloration provoked by cold exposure) as not every patient exhibits all phases. In total, 30 GCA patients were enrolled in this study. Furthermore, imaging data (PET-CT, MRI, ultrasound (US), or temporal artery biopsy (TAB) of all GCA patients were evaluated. Results 30 GCA patients were included, with a mean age of 68,6 (±6,5) years, when diagnosed. 76,7% were female. Of the 30 GCA patients, 12 (40%) reported monophasic discoloration. Of these 12 GCA patients, 2 (6,7%) patients reported bi- or triphasic discoloration. Of the 12 GCA patients with at least monophasic discoloration, 6 patients reported a new onset RP (&lt; 1 year of diagnosis). Imaging data of these 6 patients showed severe Large Vessel GCA (with subclavian and axillary involvement) in all of these patients, without displaying cranial GCA. Of these 6 patients, 1 was examined with US alone, 3 with PET-CT, and 2 had both US and a PET-CT. 3 patients reported that the RP complaints, disappeared during treatment of the GCA, 3 still had complaints. Interestingly all these 3 patients had stenosis of either the subclavian, the axillary artery, or both. Conclusion We found an increased prevalence of monophasic Raynaud’s phenomenon in GCA patients that is 3,7 times higher, when compared to a local background population 2 . When looking at new onset RP in GCA, all patients were found positive for Large Vessel GCA, without cranial symptoms. The data of this study warrants a closer look at LV involvement in patients presenting with Raynaud’s phenomenon and GCA or PMR like symptoms. References [1]Karlson, E. W. et al. A connective tissue disease screening questionnaire for population studies. Ann. Epidemiol. 5 , 297–302 (1995). [2]Abdulle, A. E. et al. Low body weight and involuntary weight loss are associated with Raynaud’s phenomenon in both men and women. Scand. J. Rheumatol. 50 , 153–160 (2021). Table 1. Presence of Raynaud’s phenomenon in GCA. GCA new onset RP (n=6) GCA pre-existing RP (n=6) GCA Without RP (n=18) All GCA (n=30) Age in years at diagnosis, mean (SD) 73 (±3,4) 63,5 (±4,9) 69,3 (±6,5) 68,6 (±6,5) Gender, women, n (%) 5 (83,3%) 5 (83,3%) 13(72,2%) 23 (76,7%) Fingers Unusually sensitive to cold, n (%) 6 (100%) 6 (100%) 4 (22,2%) 16 (53,3%) Have your fingers ever shown any unusual colour changes in the cold, n (%) 6 (100%) 6 (100%) 0 (0%) 12 (40%) Monophasic RP, n (%) Was the colour white? n (%) 6 (100%) 6 (100%) 0 (0%) 12 (40%) Multiphasic RP, n (%) 2 (33,3%) 0 (0%) 0 (0%) 2 (6,7%) Was the colour blue/purple? n (%) 1 (16,7%) 1 (3,3%) Was the colour red? n (%) 1 (16,7%) 1 (3,3%) LV GCA, n (%) 6 (100%) 2 (33,3) 10 (55,6%) 18 (60%) Disclosure of Interests Berend Slijkhuis: None declared, Maria Sandovici: None declared, Amaal Eman Abdulle: None declared, Kornelis van der Geest Speakers bureau: as an employee of the UMCG, received speaker fees from Roche which were paid to the UMCG., Elisabeth Brouwer Speakers bureau: as an employee of the UMCG received speaker fees from Roche in 2017, 2018 which were paid to the UMCG., Consultant of: as an employee of the UMCG received consulting fees from Roche in 2017, 2018 which were paid to the UMCG., Douwe J Mulder Grant/research support from: as an employee of the UMCG received research grants from Sanofi which were paid to the UMCG.